35% of Iraq vets sought therapy after war's 1st year


About a third of U.S. soldiers who served in Iraq during the first year of the war sought mental health treatment after leaving there, according to a groundbreaking study of the problem.

This is the first war in which the military has systematically assessed the mental health of returning troops. As a result, said Dr. Michael E. Kilpatrick, deputy director of deployment health support for the Department of Defense, it is impossible to compare the psychological toll of this war with previous wars.

"We recognize there have been problems after every war, the extent of which we don't know," Kilpatrick said.

The study determined that while roughly one in three returning Iraq war veterans sought treatment, the percentage of those with serious problems was smaller.

Some veterans and veterans advocates say the research, published yesterday in The Journal of the American Medical Association, provides a window into the enormous psychological and emotional toll the conflict is having on military personnel. Some also contend the military is not doing enough to deal with the problem, which they said may be larger than the study showed.

But military officials and the lead author of the study said the findings showed that the Department of Defense is responding effectively.

"The most important finding is that a large number of soldiers and Marines are using mental health services very soon after they get home," said the author, Col. Charles Hoge, a psychiatrist at the Walter Reed Army Institute of Research in Silver Spring.

He said the military's mental health support system is working, enabling many soldiers who needed treatment to get it.

Steve Robinson, director of the National Gulf War Resource Center, a veterans advocacy group, disagreed, saying many returning veterans are not receiving adequate attention. "We've got 35 years of history from the Vietnam War that if they don't receive proper care, they turn to drugs and alcohol, they lose their homes. It's happening again."

The study looked at medical records for soldiers who were deployed between May 1, 2003 and April 30, 2004, the first year of the Iraq war. Researchers analyzed data for 315,000 troops: the 222,000 who served in Iraq, plus 28,000 who were in Afghanistan, and 65,000 stationed elsewhere. The group included active-duty soldiers, reservists and National Guard members.

The study found that 35 percent of those who served in Iraq sought treatment in the year after leaving the combat zone. By contrast, 21 percent of those who had been in Afghanistan sought treatment, as did 24 percent of those who had been stationed elsewhere.

Hoge said the difference was likely due to the heightened danger and violence of the Iraq conflict. "Just about everybody who is deployed to Iraq is affected in some way," he said.

However, he emphasized that of those who had sought help after being in Iraq, only a third had received a specific diagnosis such as depression or post-traumatic stress disorder. The rest apparently had problems that weren't as serious and may have improved without further help, he said. "The vast majority who used mental health treatment came in once or twice," he said.

The rate of serious mental and emotional difficulties - 12 percent for those in Iraq - is consistent with the numbers reported by Hoge in a related study done two years ago. In that paper, he and his colleagues studied the experiences of more than 6,000 combat soldiers returning from Iraq and Afghanistan and found that about 15 percent had serious war-related psychological problems.

Some veterans said this study has likely underestimated the scope of the problem. "Even people who say they don't experience [problems], they are," said Josh Sanders, a 26-year-old Iraq war veteran who said he suffers from PTSD. He was an infantry soldier with the First Armored Division and served in Iraq for eight months starting in May 2003. Since returning to the U.S., he has suffered from anxiety, paranoia and depression and has been unable to hold a job.

"I get major anxiety attacks. I get cold sweats," said Sanders, who lives with his wife and two children in Sullivan, Ill. "I have not been the same since" leaving Iraq.

Sanders said he has several friends who are suffering from the same symptoms but have not gotten treatment.

About 1.3 million Americans have served in Iraq and Afghanistan. Some studies of Vietnam War veterans have found that as many as a third suffered from PTSD and other mental health problems. Those with PTSD are typically overwhelmed by memories and sensations of battle. They have trouble sleeping and often feel panicky, isolated, angry and depressed.

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